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参照内阁法令(现行和先前)所载决策标准对个体农户职业性听力损失风险进行的比较分析

[Comparative analysis of occupational hearing loss risk among private farmers with reference to decision-making criteria contained in the cabinet ordinances (current and previous)].

作者信息

Solecki Leszek

机构信息

Zakladu Fizycznych Szkodliwosci Zawodowych, Instytutu Medycyny Wsi im. W. Chodzki w Lublinie.

出版信息

Med Pr. 2005;56(6):451-60.

Abstract

BACKGROUND

Noise present in the agricultural environment constitutes a significant risk for the hearing organ among private farmers. The change of the principles concerning diagnostic and decision-making procedures give rise to specific consequences of an ethical, social, medical, economic or political nature. The aim of the study was to perform a comparative analysis of the occurrence of the occupational hearing loss risk among private farmers, with reference to two different decision-making criteria.

MATERIALS AND METHODS

The assessment of the state of hearing in farmers, previously carried out in a selected group of 128 people, was the major research material. A comparative analysis of hearing loss and the evaluation of the risk of occupational hearing impairment was conducted on the basis of two different decision-making criteria set forth in the Cabinet Ordinances of 2002 and 1983, supplemented with the Instruction of the Minister of Health issued in 1987. In the evaluation of hearing loss the following aspects were considered: selected age and employment duration intervals as well as selected audiometric frequencies and types of the diagnosed hearing loss (total or corrected). The analysis of occupational risk, however, was based on specified frequencies of standard-exceeding hearing loss (standard: 30 dB or 45 dB).

RESULTS

The analysis showed that the total hearing loss increased with farmers' age, whereas corrected loss was not age-ndependent. An increase in hearing loss independent on the duration of employment was observed only up to 30 years of employment; beyond this period a decrease in hearing loss (total and corrected) was noted. Standard-exceeding hearing loss, according to the 1983 decision-making criterion occurred considerably more often (11 cases; 8.6%), compared to that based on the 2002 criterion (8 cases; 6.2%).

CONCLUSIONS

Bearing in mind that the greater corrected hearing loss occurs among younger people, it is recommended to apply corrected hearing loss in the evaluation of the degree of hearing impairment. Due to more frequent hearing loss within the range of high frequencies (4 and 6 kHz), and to provide the required distinctiveness of speech (tone), the frequency of 4 kHz should be applied in calculations of mean values. The comparative analysis of hearing loss inclined us to presume that the 1983 diagnostic procedures and decision-making criterion (corrected values; frequencies: 1, 2 and 4 kHz, standard: 30 dB) should be reinstated to ensure a proper protection of workers against noise.

摘要

背景

农业环境中的噪音对个体农民的听觉器官构成重大风险。诊断和决策程序原则的变化会引发伦理、社会、医学、经济或政治性质的特定后果。本研究的目的是参照两种不同的决策标准,对个体农民职业性听力损失风险的发生情况进行比较分析。

材料与方法

对先前在128人选定群体中进行的农民听力状况评估是主要研究材料。根据2002年和1983年内阁法令以及1987年卫生部发布的指令中规定的两种不同决策标准,对听力损失进行比较分析,并评估职业性听力损伤风险。在评估听力损失时,考虑了以下方面:选定的年龄和就业时长区间,以及选定的听力测定频率和诊断出的听力损失类型(总计或校正后)。然而,职业风险分析基于超过标准的听力损失的特定频率(标准:30分贝或45分贝)。

结果

分析表明,总听力损失随农民年龄增加而增加,而校正后损失与年龄无关。仅在就业30年之前观察到听力损失随就业时长增加,超过此期限后,(总计和校正后)听力损失出现下降。根据1983年决策标准,超过标准的听力损失发生率(11例;8.6%)明显高于基于2002年标准的发生率(8例;6.2%)。

结论

鉴于校正后听力损失在年轻人中更为常见,建议在评估听力损伤程度时采用校正后听力损失。由于高频范围(4千赫和6千赫)内听力损失更为频繁,且为提供所需的语音清晰度(音调),在计算平均值时应采用4千赫频率。听力损失的比较分析使我们倾向于假定应恢复1983年的诊断程序和决策标准(校正值;频率:1、2和4千赫,标准:30分贝),以确保对工人进行适当的噪声防护。

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